Treatments
Vulval clinic
The vulval clinic is a dedicated clinic for problems of the external genitals (the vulva). Many women live with symptoms such as itching, pain or skin changes for a long time. These can have a considerable effect on daily life, relationships and sexuality.
At the vulval clinic we take the time to assess your symptoms carefully and to draw up a suitable treatment plan with you.
Our expertise
A particular area of expertise at Femmecare
The vulval clinic is a particular area of expertise at Femmecare. Vulval symptoms call for specific knowledge: many conditions cause similar symptoms, such as itching or pain, but each needs a different treatment. That is why, at the vulval clinic, you see a gynaecologist who specialises in conditions of the vulva.
In figures
You are not alone
Vulval symptoms are common, but rarely talked about. As a result, many women live with them for a long time.
- 1 in 5sexually active women in the Netherlands sometimes have pain, itching or a burning feeling during sex.
- 1 in 20women experience this regularly or often.
- 1 in 3women attending a vulval clinic turn out to have lichen sclerosus. It is the most common diagnosis made there.
- 5 to 8%of women of childbearing age have thrush more than three times a year.
Sources: Dutch guideline Vulvodynie (NVOG, richtlijnendatabase.nl), diagnosis module (Kedde, 2012); Dutch guideline Lichen sclerosus (richtlijnendatabase.nl), epidemiology module (Cheung, 2006); NVDV, Dutch guideline on sexually transmitted infections, chapter ‘Fluor vaginalis en vaginitis’ (2024).
Symptoms
Which symptoms can we help with?
You can come to us for, among other things:
- Itching or a burning feeling
- Pain during intercourse
- Sores, splits or changes in skin colour
- Recurrent infections
- Suspected or known lichen sclerosus or another skin condition, including a known condition that is flaring up again
- Long-standing vulval symptoms with an unclear cause
Sometimes symptoms have been treated before but keep coming back. We then look again, carefully, at the cause.
Possible causes
Examples of conditions we can help with
Vulval symptoms can have many different causes, and sometimes several factors play a part at once. That is why we first work out carefully where your symptoms come from. Below are some examples; we can help with many more vulval problems.
Lichen sclerosus
A long-term skin condition of the vulva. The skin becomes thin and white and can itch, burn or split. With a potent steroid ointment, a greasy ointment and regular review, symptoms can usually be kept well under control.
More about lichen sclerosusThrush or bacterial vaginosis
Infections can cause itching, irritation and abnormal discharge. If they keep returning, we also look at what is contributing to that.
More about vaginal dischargeThinner mucous membrane (atrophy)
With less oestrogen, for example around and after the menopause, the mucous membrane can become thinner and more fragile. An oestrogen cream can help.
More about menopause symptomsPain during sex
Persistent pain, or fear of pain, on penetration (dyspareunia or vaginismus). Where needed we work together with a pelvic physiotherapist or psychologist.
Bartholin's cyst
A swelling at the entrance to the vagina caused by a blocked gland. If needed, the cyst can be opened at the clinic under local anaesthetic.
Skin changes or discolouration
We examine any area that looks different or does not clear up on its own, so we know what it is and which treatment fits.
Other examples
- Lichen planus
- Lichen simplex (chronic itching and scratching)
- Herpes
- Genital warts
- Eczema
- Psoriasis
Your visit
What happens at an appointment?
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A detailed conversation
At Femmecare we always start with a detailed conversation. We discuss:
- your symptoms
- previous treatments
- the effect on your daily life
-
Physical examination
In many cases a physical examination follows. This is always done in agreement with you.
Sometimes further tests are needed. The doctor will explain what will happen and why.
-
Treatment plan
We explain the findings clearly and draw up a treatment plan with you that fits your situation. The aim: fewer symptoms, more comfort and a better quality of life.
Treatment
Treatment at the vulval clinic
Treatment depends on the cause of your symptoms.
- Medicated ointment or cream
- Steroid or hormone ointment
- Advice on skin care
- Treatment of infections
- Support with long-term skin conditions such as lichen sclerosus
- Minor surgical procedures (as an outpatient, under local anaesthetic)
With long-term conditions, clear explanation and ongoing support matter. We provide clear instructions and follow-up appointments where needed.
Working together
Working with other specialists
When several factors play a part
Sometimes several factors play a part, such as hormonal changes, pain problems or psychological strain. Where needed we work together with other care providers.
For complex problems
Where problems are complex, or a malignancy is suspected, we work together with the hospital.
See also
For GPs
Referring to the vulval clinic
Diagnosis and treatment of vulval symptoms by gynaecologists with expertise in vulval pathology, in line with the Dutch NVOG guidelines.
ZorgDomein: ‘Femmecare Clinics’
Reasons to refer
- Pruritus vulvae with no clear cause or an insufficient response to treatment
- Suspected lichen sclerosus or another vulval dermatosis
- Recurrent vulvovaginal infections
- Dyspareunia or genitopelvic pain
- Persistent vulval skin change or discolouration
What we offer
- History, inspection and, if needed, culture or PCR
- Vulval biopsy under local anaesthetic
- Incision of a Bartholin's cyst
- Treatment and follow-up of lichen sclerosus
- Feedback to you as the referrer
Our approach
We take your symptoms seriously, explain the findings clearly and draw up a treatment plan that fits your situation. Would you like an appointment? First discuss with your GP whether a referral to Femmecare is appropriate.